Higher Aldosterone Levels Tied to Incident Type 2 Diabetes Risk

MONDAY, Sept. 10, 2018 — Higher levels of aldosterone are associated with insulin resistance and incident type 2 diabetes mellitus among multiethnic individuals, according to a study published in the Sept. 4 issue of the Journal of the American Heart Association.

Joshua J. Joseph, M.D., from The Ohio State University in Columbus, and colleagues assessed associations between aldosterone and plasma renin activity with fasting plasma glucose, insulin resistance, β-cell function, and incident diabetes mellitus among 1,570 adults participating in the Multiethnic Study of Atherosclerosis.

The researchers found that there were 116 cases of incident diabetes mellitus over 10.5 years of follow-up. A 100 percent increase in log-aldosterone was associated with a 2.6 mg/dL higher fasting plasma glucose, 15 percent higher homeostatic model assessment of insulin resistance (HOMA2-IR) and 6 percent higher HOMA2-β (P < 0.01). Further, a one-standard-deviation increase in log-aldosterone was associated with a 44 percent higher risk of incident diabetes mellitus (P < 0.01). The greatest increase in risk (142 percent; P < 0.01) was seen in Chinese-Americans (P for interaction, 0.09 versus other ethnicities). In fully adjusted models, log-plasma renin activity was not associated with incident diabetes mellitus.

“Aldosterone is associated with glucose homeostasis and diabetes mellitus risk with graded associations among Chinese-Americans and blacks, suggesting that pleiotropic effects of aldosterone may represent a modifiable mechanism in diabetes mellitus pathogenesis with potential racial/ethnic variation,” the authors write.